Entire Transcript in Adobe Acrobat Format - National Reference ...

Entire Transcript in Adobe Acrobat Format - National Reference ... Entire Transcript in Adobe Acrobat Format - National Reference ...

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267 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 for NIH was extended to the whole of the Public Health Service and this begins part of the history of the discomfort in this area because the moving force remained the NIH and the IRB/DRG. (Slide.) In 1972 Robert Marston, who was Director of the National Institutes of Health, faced with the emerging scandal of the Tuskegee study, which had been a PHS study and not an NIH study but was focusing on the government's involvement in research and with Senate hearings going into a wide range of other questionable research, changed the Institutional Relations Branch into the -- that aspect of their work into the Office for Protection of Research Risks, which he lodged in the Office of the Director. (Slide.) At this time there were some in Congress who favored enacting legislation with sanctions for violations of human subjects rights but this was steadfastly opposed by the National Institutes of Health and eventually an agreement was worked out and the DHEW relented on the notion that it should not have any regulations as such. There previously had been a policy, not regulations. They should not have regulations. They agreed they would have regulations and the Senate backed off of the notion of

268 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 legislating this. So the provisions of the 1974 Research Act were limited. It, of course, established the National Commission to study this area but beyond that it established the firm requirement that regulations would be issued that would have informed consent and prior review through an Institutional Review Board and it also made clear that the department had the responsibility to provide consultation and education on the subject. (Slide.) The National Commission recommendations which were all forthcoming by 1978 were largely adopted. Of course, children and the mentally infirmed, institutionalized and mentally infirmed were not accepted. The children were later and much more recently adopted. These became the basis for the 1981 regulations which are really the framework that we still have. The President's Commission recommended the Common Rule on Human Subjects for protection from all the 20 plus agencies that support such research and that occurred in 1981. A decade later for reasons that Joan Porter nicely surveyed for us that Common Rule was finally published in the Federal Register and one of the things we are still studying is the difficulty in having it truly be

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legislat<strong>in</strong>g this. So the provisions of the 1974 Research<br />

Act were limited.<br />

It, of course, established the <strong>National</strong><br />

Commission to study this area but beyond that it<br />

established the firm requirement that regulations would be<br />

issued that would have <strong>in</strong>formed consent and prior review<br />

through an Institutional Review Board and it also made<br />

clear that the department had the responsibility to provide<br />

consultation and education on the subject.<br />

(Slide.)<br />

The <strong>National</strong> Commission recommendations which<br />

were all forthcom<strong>in</strong>g by 1978 were largely adopted. Of<br />

course, children and the mentally <strong>in</strong>firmed,<br />

<strong>in</strong>stitutionalized and mentally <strong>in</strong>firmed were not accepted.<br />

The children were later and much more recently adopted.<br />

These became the basis for the 1981 regulations<br />

which are really the framework that we still have.<br />

The President's Commission recommended the<br />

Common Rule on Human Subjects for protection from all the<br />

20 plus agencies that support such research and that<br />

occurred <strong>in</strong> 1981. A decade later for reasons that Joan<br />

Porter nicely surveyed for us that Common Rule was f<strong>in</strong>ally<br />

published <strong>in</strong> the Federal Register and one of the th<strong>in</strong>gs we<br />

are still study<strong>in</strong>g is the difficulty <strong>in</strong> hav<strong>in</strong>g it truly be

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